Utilization Review Support Specialist

Novant Health; Mount Pleasant (SC); Hybrid; USD 32,000 - 52,000; Full time

Benefits offered by this job

Hybrid work opportunity

Job summary

Novant Health is seeking a detail-oriented administrative support specialist to assist the Utilization Review team. Responsibilities include payer communication, authorization tracking, and handling UR office operations in a busy medical setting.

The role requires at least one year of clerical/healthcare experience, strong Microsoft Office skills, and excellent communication with patients and payors. This is a hybrid position with standard daytime hours.

Qualifications

• One year of clerical and healthcare experience.
• Excellent interpersonal and customer service skills.
• Proficient with Microsoft Office; able to keyboard accurately.

Responsibilities

• Schedule: Monday–Friday, daytime hours, rotating holidays.
• Provide administrative and technical support to the Utilization Review team for payer communication and documentation.
• Manage daily UR office operations, including mail processing, calls to verify authorizations, and faxing for multiple facilities.
• Process denials within a strict timeframe and manage payor queues to avoid adverse determinations.
• Facilitate EMR access by sending census reports to payors.
• Process large volumes of confidential patient and payer data to support billing workflows.
• Establish and maintain effective relationships with internal and external customers.
• Maintain compliance with regulatory standards and organizational policies.

Skills

Interpersonal skills

Customer service

Typing accuracy

Attention to detail

Planning and organizational skills

Effective written and verbal comms

Education

High School Diploma or GED

Tools

Microsoft Office

Job description

What We Offer

• Comprehensive benefits include medical, dental, vision, and life insurance.
• Retirement fund with matching contributions.
• Tuition assistance for qualifying team members.
• Employee assistance programs and discounts.
• Hybrid work opportunity.

What You'll Do

• Schedule:Monday – Friday, daytime hours, rotating holidays.
• Provide administrative and technical support to the Utilization Review team to ensure timely payer communication, authorization tracking, and accurate documentation.
• Manage daily operations of the onsite Utilization Review (UR) office, including processing mail, answering phone inquiries, making calls to verify authorizations and denial determinations, and faxing communications for multiple facilities.
• Process denials within a strict timeframe and manage payor work queues to avoid adverse determinations.
• Facilitate EMR access by sending census reports to payors.
• Process large volumes of confidential patient and payer information to support billing workflows (includes managing payor communications, processing authorizations, addressing denials, and indexing faxes).
• Establish and maintain effective work relationships with both internal and external customers.
• Maintain compliance and regulatory standards and organizational policies.

What We're Looking For

Required:

• Education: High School Diploma or GED.
• Experience: Minimum of one year of clerical and healthcare experience.
• Additional Skills (required):Excellent interpersonal and customer service skills. Working knowledge of personal computers and software including specific knowledge of Microsoft office products. Perform clerical duties with accuracy. Proficient spelling and grammatical skills. Attention to detail with excellent planning and organizational skills. Communicate effectively in both oral and written forms. Keyboard/type accurately. Ability to operate standard office equipment including, but not limited to, a calculator, fax machine, copier, printer and scanner. Establish and maintain effective work relationships. Ability to successfully complete generic and department specific skills validation and competency testing.

Preferred:

• Knowledge of Microsoft Office products with proficiency in Excel and Word.
• Revenue cycle experience working with different payer types and working knowledge of their requirements.

Why Choose Novant Health?

At Novant Health, we believe remarkable care starts with compassion for our patients, our communities, and each other. We value belonging, courage, personal growth, and teamwork, creating a space where everyone is respected, supported, and safe to show up as their full selves.

Job Opening ID

185138